1932228467 NPI number — KNOX COUNTY AGING CENTER

Table of content: (NPI 1932228467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932228467 NPI number — KNOX COUNTY AGING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOX COUNTY AGING CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932228467
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 306
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOX CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-657-3618
Provider Business Mailing Address Fax Number:
940-657-3618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 N AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOX CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-657-3618
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLOYD
Authorized Official First Name:
TRAVIS
Authorized Official Middle Name:
C
Authorized Official Title or Position:
COUNTY JUDGE
Authorized Official Telephone Number:
940-459-2191

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X , with the licence number:  332U0000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000183400 . This is a "VENDOR NUMBER-DADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001013086 . This is a "VENDOR NUMBER DADS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".